Fecal Microbiota Transplantation for Treatment of Refractory Graft Versus Host Disease-a Pilot Study
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Fecal Microbiota Transplantation in GVHD
- Sponsor
- Shanghai Children's Medical Center
- Enrollment
- 15
- Primary Endpoint
- Efficacy of FMT in the treatment of refractory GVHD on day 7
- Last Updated
- 7 years ago
Overview
Brief Summary
The study evaluates safety and efficacy of fecal microbiota transplantation (FMT) for the treatment of refractory graft-versus-host-disease (GVHD) of the gut. FMT might be a beneficial treatment in this clinical situation with a poor prognosis and limited therapeutic options.
Detailed Description
Graft-versus-host-disease (GVHD) is a major complication after hematopoietic stem cell transplantation (HSCT). Gut is the most vulnerable target organ of acute GVHD. Patients who have a gastrointestinal acute GVHD received a first-line standard treatment of corticosteroids. For patients who do not respond or progress after an initial response have a high mortality. Therefore, the investigation of effective second line therapy for these patients are in need. The study evaluates safety and efficacy of fecal microbiota transplantation (FMT) for the treatment of refractory GVHD of the gut. FMT might be a beneficial treatment in this clinical situation with a poor prognosis and limited therapeutic options.
Investigators
Cao Qing
Director of Infectious Diseases
Shanghai Children's Medical Center
Eligibility Criteria
Inclusion Criteria
- •3-18 years of age
- •Allo-SCT patients with acute steroid-resistant GI-related GVHD grade III-IV. Steroid-resistant GI-related GVHD will be defined as lack of improvement (same stage) or worsening of GI symptoms after 7 days of steroid therapy (≥ 2 ml/kg of IV methylprednisolone)
- •No definite contraindication for gastrointestinal endoscopy
- •Signature of informed consent by the legal guardians of patients
Exclusion Criteria
- •Prior inclusion to an interventional study
- •Previous Allo-SCT
- •Known multi-drug resistance carriage prior to stool collection
- •Severe colitis of any etiology or a history of inflammatory bowel disease (IBD)
- •Uncontrolled infection (hemodynamic instability, ongoing high fever or bacteremia within 3 days after antibiotics administration)
- •Active GI bleeding
- •Absolute neutrophil count \< 500 cells/microL
- •Absolute platelet count\< 10 x 109 /L
- •Patients who cannot give informed consent
Outcomes
Primary Outcomes
Efficacy of FMT in the treatment of refractory GVHD on day 7
Time Frame: 7 days following FMT
Participants will be evaluated on days 7 following FMT. The volume and frequency of daily diarrhoea will be continuous observed and recorded in 7 days.
Efficacy of FMT in the treatment of refractory GVHD on day 28
Time Frame: 28 days following FMT
Participants will be evaluated on days 28 following FMT. The volume and frequency of daily diarrhoea will be continuous observed and recorded in 28 days.
Secondary Outcomes
- Treatment-related AEs and SAEs(up to 28 days following FMT)
- GVHD severity(up to 28 days following FMT)
- Implantation rate(through study completion, an average of 6 months)
- Survival rate(through study completion, an average of 6 months)
- Change in biomarkers(up to 28 days following FMT)
- Number of patients with infectious disorders(through study completion, an average of 6 months)
- Quality of Life(up to 6 months following FMT)